Black men are at double the risk of prostate cancer compared to white men

Black men in England are at double the lifetime risk of being diagnosed with, and dying from, prostate cancer compared with white men in England, according to research published in the open access journal BMC Medicine.

The study also finds that Asian men have around half the lifetime risk of being diagnosed with, and dying from, prostate cancer compared with white men in England. The new figures could help individuals better understand their risk of developing prostate cancer and make an informed decision about whether or not to have a prostate specific antigen (PSA) test.

Prostate cancer is the most common cancer in men in the UK, with 41,736 diagnoses in 2011, and it is predicted to become the UK’s most commonly diagnosed cancer overall by 2030.

Researchers from Prostate Cancer UK and Public Health England estimated that the lifetime risk of being diagnosed with prostate cancer in England is approximately 1 in 8 (13.3%) for white men, 1 in 4 (29.3%) for black men (including Black African, Black Caribbean and Other Black) and 1 in 13 (7.9%) for Asian men (including Indian, Pakistani, Bangladeshi and Other Asian).

The lifetime risk of dying from prostate cancer in England is estimated to be approximately 1 in 24 (4.2%) for white men, 1 in 12 (8.7%) for black men and 1 in 44 (2.3%) for Asian men.

Lead author Alison Cooper from Prostate Cancer UK said: “We already knew that black men were more likely to be diagnosed with prostate cancer than white men, however, the data we had was fast becoming out of date. The study also provides important absolute risk figures to help black men better understand their risk of developing prostate cancer. These figures can be used for targeted awareness-raising and to help them make an informed decision about whether or not to have a prostate specific antigen (PSA) test.”

The researchers studied prostate cancer incidence and mortality data for England for the period 2008-2010 from a combination of sources including Public Health England, Office for National Statistics, and the national census, yielding a total sample size of 25,635,649 men, including 102,252 prostate cancer diagnoses and 26,521 deaths due to prostate cancer.

When comparing the lifetime risk of dying from prostate cancer with the lifetime risk of being diagnosed with prostate cancer, within each ethnic group, the results show that white, black and Asian men with a prostate cancer diagnosis all have a one third chance of dying from the disease, independent of their ethnicity. Nonetheless, proportionally more black men are dying from prostate cancer in England, since proportionally more are diagnosed in the first place.

The authors caution that each individual man’s risk is different and will vary based on a combination of factors in addition to ethnicity, such as age, family history of prostate cancer, and body weight.

The study does not provide reasons for the increased risk of prostate cancer in black men, and the authors say further work is needed to understand the mechanisms behind this higher than average risk.

The analyses were based on a number of assumptions and considerations, most of which were required to address the lack of available data by ethnicity. The authors say that this highlights the urgent need for more routine collection of data that captures ethnicity. Some records were also based on self-reported ethnicity data, and the study does not provide information on men of mixed ethnicity.

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